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ELECT#�ICAt� PERMlT APPLIG;aTlt��l
<br /> CI7Y�F EVERETT PERMtT SERVtCES
<br /> 32{�4 CEC�A#�STREET,�VEF2E�'T,1►VA 9824'#
<br /> {P}425�257-881 tl � FAX 425-257-SSr7 0 �E}everetfieps�everett�nra.gov j www.everetf�,ra.gavl�rmits
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<br /> ��o,r�c�r a�n�t�ss: 1{�Q1 C�Ib Ave` _
<br /> BUtLDiN�AREA{If residential,new canstruetion,remodel,or additian) ��� SF
<br /> BUtLblNG TYPE: ❑SFR-bETAGNEQ �SFR-A'1'TAGHEQ �Zl DtIPLEX Cl[irlllLT1-FAMIL�'-#OF UNITS: CI Gt>MiutERCIA�
<br /> USE OF BUILDING: Resid�tltl�i Home
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<br /> +C�NTRA�1'PRICE OF'WGRK:$ �;65(3.0(}
<br /> MVl}MBER K�F DEVIGES if low vafta e :
<br /> FtR��41�M? C]Y�� C��It'�
<br /> 1�S�CfG1ATED BUiI.QING PERMIT# if:a {iceble;
<br /> ES�RIF?ION QF"fA�#�ft#C4 S��iT�d�t�i1�'CE�1l�t;�'��t��"�,'���P£���'���;Q?��
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<br /> c�wt��i��r��.it����oR�ss: 5,���r PC3 Box 131�(
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<br /> OWNE#t:PHONE: owN��a E���.:
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<br /> conrT�cro�x N,an�E:Wyatt Electric and Construction LLC.
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<br /> �,�Granite Falls sTA,�wa z�P 98252
<br /> CtaNTRA�TQR PHiJNE:�2�-870-5485 cota�r.�►cxc��E�na��;: Wyattelectrical:a�ce t'�")z gmaii.com
<br /> +�e��r�caa��,�,�t�Eau►e��: V�/yattEC854JL c��nr a���►�����su�tr��ss c.�c.�i���u�����0544�2
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<br /> PF�1�l�Y CtJNTACT: C]OWNER C��ONTRACTQR I7 O'I'HER(F'leas�Specify)
<br /> �o�a�r��e�; �o�rAcr��a��;.����5:�59�9
<br /> I��'� . '� c�����m��.:�ya�e��ctr�c�g�a�.cear�
<br /> AGR�EM�'NT;1 herehy certiFy thaf!haue read and exarnined this apptication and knnw ttae sarrrs#a b�true and correct. A!t provisians df Faws and ar�nanees goveming this rype
<br /> af work wi7f be campleted whather specifted Ae�etn ar nat.: The grsnting of a psrmR does nDt prestrme to give authority to violafe ar caneet tha provisians of any other state or
<br /> lacat taw resutaUng constructron vr ihe:perfarmaetce af consfruction: Thet 1 am authorized t�y the ownsr of fhis,o+'operty to perform fhe work for wh�h apptiaafion is made�nd I
<br /> compJy with fhe Sfafe GonEracto�s Law Y&.27 RG!'J arad 298.204 WAG.
<br /> City af Everett 0tficJat Use C1nfy
<br /> t'ERMIT#
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<br /> dwn utharizeQ Agent Sig ture Date {Revised 9f23/201fi)
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